Before I retired, I naively anticipated that the day after my last clinic, all my anxiety would melt away, like the Cadbury’s Flake I found under the spare wheel of my car the other day.
When I fantasised about reaching my retirement, I pictured myself floating on air, with not a care in the world, other than trying to figure out which colour bin to put out on a Monday night.
Earlier this week, I finished therapy.
Nearly two years after retirement, I found my anxiety and stress had quadrupled to a level where I was finding it difficult to function – even though these days ‘function’ involves tweeting and scouring the internet to see if there are any new YouTube videos of yampy ‘natural’ cures for receding gums.
I’ve written before that for a few years prior to retiring, I’d suffered from (literally) blinding migraines, often during a working day. The situation became intolerable and eventually I realised my brain was trying to send me a message and when I was advised that I could retire from the Nash early, I grabbed the opportunity with alacrity.
A few months ago, my new levels of anxiety became extreme, and it was only because of another bout of the COVID’s in November, that I didn’t seek help sooner.
Most dental professionals, particularly dentists, will recognise that state of anxiety and stress that grips you and keeps you in a state of readiness for an attack – whether it be from a patient, the GDC, or an outfit of ambulance-chasing solicitors.
Relatively recently, I felt like I was constantly in the middle of an adrenaline rush and during the summer of 2020 I found myself in the local Accident and Emergency Department on an ECG machine, being diagnosed with atrial fibrillation.
Early in my career – and by early, I mean VERY early – it was actually on undergraduate restorative clinics – I began to experience massive palpitations. The palpitations would take the form of tachycardia, punctuated by loads of missed beats. This dogged me pretty much throughout my career. A number of times I’d get to the GP’s surgery and by the time I was on a machine, my heart rhythm had gone back to normal.
It got to the point where I had the feeling I was being marked down as a hysteric, since two ambulatory cardiac monitors failed to pick any abnormality up.
Long story short, my beloved Apple watch’s inbuilt ECG facility picked up that I had an abnormality. Mercifully, the young house officer took it seriously, immediately put me on her ECG machine and it confirmed that I was, indeed, in atrial fibrillation. A couple of minutes later, I flipped back to normal sinus rhythm.
Later, I was formally diagnosed with paroxysmal atrial fibrillation – which in retrospect had obviously dogged me for years – and the cardiac specialist advised me to avoid stressful situations! Advice that was thirty-seven years too late.
In late 2019, my mother, who lived alone, broke her hip. Unbeknown to me, I was actually suffering from COVID-19 (by that time it was only an unnamed ‘virus’ that had been mentioned as occurring in Wuhan) and I was too ill to visit her in hospital. As it happens, I’d unintentionally self-isolated.
When she was discharged, a hospital bed was put in her house and a care package was put into effect. I visited her every day to do shopping and generally help out.
After only about a week, I realised my mum wasn’t eating and was trying to hide the fact, by wrapping her food up in tissues. At one point she ended up in hospital again, this time with dehydration. By that time, we were in lockdown and I wasn’t able to go to the hospital.
One day I received a call from the geriatrician who was looking after her. She asked me for my opinion on my mother’s mental state. She wondered if she was depressed. I had to say, she didn’t seem that way. The consultant agreed and asked if I had any views on what was going on in my mum’s head. At that point, she had refused treatment for another problem which the doctor felt needed addressing.
I said “I think she is trying to finish herself off.” The doctor agreed and she was sent home with a terminal care package.
Watching my mum starve herself to death was incredibly stressful as you could imagine, as was the performance I had to go through after my mother’s death in order to get a death certificate, because she hadn’t been seen by her own GP for a month prior to her demise.
We were allowed only six mourners at my mum’s funeral and my younger brother, who I hadn’t seen for a couple of years, travelled up from South Wales and stayed overnight.
I met him at New Street Station, and I didn’t recognise him. He looked really ill, but I knew he had been having a stressful time at work. He was a senior psychiatric nurse and he was at the time working in a care home where they’d had an outbreak of COVID.
Again, long story short, within two weeks I had a call from my sister-in-law to say he had been diagnosed with terminal cancer and within two months, he was dead.
The only good that came out of his illness and my retirement was that me and my youngest brother, who lives in Austria and had effectively been made temporarily redundant due to the country’s lockdown rules, were able to spend some time with him – something that we hadn’t been able to do for years due to work pressures.
Now you can say that it wasn’t particularly surprising that I developed a bout of atrial fib after all that. If that was the only consequence of my appalling year, I would have lived happily with it.
But what actually happened was that I found myself constantly on edge – effectively waiting for the loss of another loved one.
If one of my kids didn’t text back immediately, I’d picture them in a fatal car crash. If my wife was longer than expected on a shopping trip, she was similarly in an accident. My son lives in London. If I read of another stabbing attack in the capital, I’d look for the age of the unnamed victim and the area of London in which it happened.
It got to the point that when I realised that the Apple ‘Find My’ facility could track my wife’s movements from my phone, I would track her movements every time she went out. If I saw that her phone wasn’t moving when she was en route to her destination, I assumed she was in a crash.
I admit that it was in retrospect, irrational, but there again, I’d lost my first wife from cancer many years ago and nearly lost my son after a critical illness seven years ago. As my therapist pointed out, I was constantly in a state of anxiety and ‘readiness’ for the next disaster. Although I had precedent for feeling that way, I felt it was still an irrational state to get in.
But I realised I was feeling EXACTLY the same as I felt in practice. I was constantly in a state of ‘readiness’ for the next disaster – whether it be a patient simply passing out or crying – a fractured root during an extraction – or a confrontation or the dreaded recorded delivery post. It all built up.
Of course, over the years, the fear of litigation or disciplinary action against practitioners HAS grown exponentially and I’ve seen colleagues and friends in tears over recent years, frightened almost to death by the prospect of the end of their dental careers just because of a fairly trivial event that occurred during their working day.
Shortly after I retired for example, I got involved with helping a colleague with her response to a woman who had gone to a litigation solicitor because she’d developed a dry socket. A DRY SOCKET! My friend was in bits, so I took over the correspondence on her behalf. The solicitor was obviously an amateur with dental litigation and the matter was dropped after my letters which gave her the clear message that we weren’t taking it seriously, we weren’t going to bother the indemnity people with it, and we thought the solicitor was an idiot. (But don’t try this at home folks).
That’s just one example, but I know shiploads of dentists, particularly young ones, who very early on in their careers are actually thinking about giving the profession up because they can no longer bear the stress.
And the number of dentists who get claims from patients nowadays. would have been unthinkable when I first qualified in the late eighties. The danger of litigation is real and if I was still in dentistry, I know I would have felt swamped.
The problem is that the stress in dentistry can be overwhelming. There are dentists who seem to be able to cope with the stresses and somehow manage to shrug them off. I have nothing but admiration for them.
But I know that for many dental professionals, the stresses and anxieties can be overwhelming and can spill over into their home and personal lives.
I freely admit that I was a complete pain-in-the-bum to live with at home when I was working, but somehow managed to keep a lid on my miserable demeanour at work. I don’t know how the partners and spouses of dental professional’s cope.
My problem, when in practice, was that I thought I was the only one filled with anxiety. It wasn’t something I thought I could talk to anyone about – especially other dental colleagues.
It was very late on (much too late) that I realised there are loads of dental people out there who felt exactly as I did. I really feel that if I had spoken to people about the way I was feeling, it would have made me feel ‘normal’ and I might have found some way of putting my anxieties into perspective.
The therapy I’ve just undergone involved my psychotherapist using a new technique I’d not heard of.
It was frankly, painful at the time, but I can’t say I even dwelled on stuff we talked about during the sessions, but one day I woke up and realised all my irrational anxieties had gone, and all the rational worries I had though still there a little, didn’t seem insurmountable any more.
That’s my story. Mental issues dogged much of my career and I truly regret having not spoken about my anxieties many years ago.
But now I feel the problems associated with dental practice are coming more into the open, we need to talk about it even more.
So with that, I’m going to make an unashamed plug for ‘Mental Dental – Group For Dentists In Crisis’ which operates on Facebook. The group was founded by Lauren Harry and it provides a non-judgmental platform for dental professionals to discuss their anxieties and stressors with others similarly affected.
My latest anxieties weren’t dentally-related so I needed to speak to get help from a professional.
My advice is, if you find speaking to like-minded colleagues doesn’t help completely, I can only plead with you to seek professional help. It didn’t cost a bomb and the relief it brought was priceless.
I will end with a Gary Delaney Joke:
“My grief counsellor died. But he was so good, I didn’t give a shit.”
Amen to that.